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0024 FORSYTH COURT
�� �02 S S� �p u�- y - , .� �� Town of BarnstableBuilding �� Yam.... �. Post This CarAUNT Fa it is„Ursible From the Street Approved Plans Must be Retained on Job and"this CardMust:=be Kept } r �, 'etz a -Poste s „'... �,.. ...; .z �.., ,. tl Permit_ WhereCertificateof OccupancywisRequfred,sucfi Butldmg shall Not be Occupied-until aFinal Inspection hasten made „xis Permit No. B-19-443 Applicant Name: todd leduc Approvals Date Issued: 02/12/2019 Current Use: Structure _ _ Expiration Date: 08 12 2019 Foundation: Permit Type: Building Insulation Residential P / / Location: 24 FORSYTH COURT,COTUIT Map/Lott' 055 059 Zoning District: RF Sheathing: Owner on Record: SULLIVAN,VERA LEE TR Contractor Name: TODD LEDUC Framing: 1 Al Address: 24 FORSYTH COURT Contrractor License CSSL 106019 2 , 497.00 COTUIT, MA 02635, Project Cost: $5, Chimney: Description: Insulation;see contract a Permit Fee: $85.00 Insulation: g Fee Paitl $85.00 Project Review Req: . Final- Date 2/12/2019 r o- 0, � � � ,� Plumbing/Gas 4 Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within socmonths afferissuance. All work authorized by this permit shall conform to the approved appl ation and'the approved construction documents,f'or which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning.,by lawsand codes. This permit shall be displayed in a location clearly.visible from access street or road�a d shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. �� y Electrical The Certificate of Occupancy will not be issued until all applicable signures by at the Building an OP'ire Officials=are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing ` , v Rough: 2.Sheathing Inspection • =., .. .. .._" 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy _ Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT c ►-Z-17/1� �ok OYII6 EVE Town of Barnstable *Permit# Expires 6 montl froi i issue i7 Regulatory Services Fee r * BAMSfABM • MASM Richard V.Scali,Director 039. ArEp MAC a Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESSYERQUT APPLICATION - RESIDENTIAL ONLY as � Not Valid without Red X-Press Imprint Map/parcel Number . Property Address Ld d S t✓ Residential Value of Work$ fS`C>U cam. J Minimum fee of$35.00 for work under$6000.00 / Owner's Name&Address c�v�l ✓ /�G a ` C�``�- e&74' Contractor's Name �/ �� Telephone Number SOU 22 78 Home Improvement Contractor License#(if applicable) /7 7Y-0-2 Email: t,u"t Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance - Check one: NOV 2 4 2015 c©'I am a sole proprietor , ❑ I am the Homeowner TOWN OF BARNSTABLE . ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) A ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to/UGw 6e y -o__�nn ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) g 2'Re-side [�}Replacement Windows/doors/sliders.U-Value 3 V (maximum.32)#of windows 3 #of doors: O ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections fequired. , Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. t ***Note: Property Owner must sign Property Owner Letter of Permission. t A copy of the Home Improvement Contractors License.&Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\buLding permit forms\EXPRESSedoc Revised 040215 J� .� Tlie Commonivealtih o -Vassachusetts Department of Industrial Industrial Accidents Office o f investigations' 600 Washington Street ti Boston,MA 02111 }4'PV11?711a.��oV�dl11 i Workers' Campensat on Insurance Affidavit:Builders/Contracturs/EIecEricians/Plumbers Applicant Information Please Print 1*.MbIX Naxos(Buusuessforz a�onll�zlnal}: Cv�..- P Address Cityf tatef • /�/ e,l 6�/ Phone Are you an employer?iMeckifie appropriate box: Type of project(required) 1.❑ I am a employer v ith 4. ❑I am a general contractor and I employees(full azrd�`or part-time).* have hired.the sub-contractors ❑New construction 2.[DI am a sole proprietor or partner- I fisted on the attached sheet. 7. [! Remodel ug s and have noemployees. Thesesob-c=trac#ors lave ' �P .� $. ❑Demolition w Q forune in an capacity- employees andhxv4 workers' °fib Y �tY # 3. ❑Building addition [No iiiorloers'comp.insurance Comp.fimu xe required-] 5. ❑ We are a corporation and its '. 10.❑Electrical repairs or additions officers have exercised their 3.❑ F am a homeoumer rifling all work 11_❑Plumbing repairs or$ddititms mysmml f[No workers.'{,NV- right of exemption per MGL 12.0 Roofrepairs � insurance required]F c.152,§1{4�and we have na employees.[To workers' I3.❑Other camp_insurance required.] `Any Wlicavt dwt checks box#1 mast also fill out the section below shmEiag their vmdexe compevsatiaa perry infocasocrL ?Homeowners who submit this afiidmit iuuffxatmg they are domg all wadi and then hire oat d&contractors coact submit a new aSdarit indicaung sacb_ fContractots that check this boa must attached sir additianal sheet dbmring the name of the sub-contw-tv¢s and state whether or nut tbose entities hzve employees.If the sub-contacturshwe employtes,they=arpmr-ide their worker'-comp.policy number. I ant an empIayer that isprmzding tvarkers'conWaisatiort iimtrance,jbr av:y enxpIgf.ees Betosv is the policy and jab site informaiom Insurance Company Nam: Policy 44,-or Self-ins-Lic. Eipiration Date: Job Site Address City/S#atelY.tp: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date.).,- Failure to secure:coverage as required under Section 25A of MGL c. 1527 can lead to the imposition of criminal penalties of a fine up to$1,500:00 andlor one-year imprisonment,is weft as civil penallies.i n the form of a STOP WORK ORDER and a time of up to$250-DO a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Imvtesdgations of the DIA for insurance:coverage verificatitm. Ida hereby ce&fjt under tha pains and penatties o,fpedwy fhatthe irziormaiion ptm &d abates is hus and correct Siffiature: Date: Phone• `Oi �7 23-� a,fjdcial use only. Do not wrke in thb area,to be winpleted by city orrou n officiat City or Tomm: Perms tUcense if Issuing A.nthority(circle one): 1.Board of Health 2.Building Department 3.Cityfroym Clerk 4.Electrical Inspector rr.Plumbing Inspector 6.Other Contact Person:_ Phone#• 1 Information and Instructions q. Massachusefts Geheral Laws chapfieir 152 requires all employers to provide workers'compensation for their employees. an ire is defined as."_.every arson in the service of another under any ccm Tact of hire, pmsaantto this sty, �P�3' P express or implied,oral or wrii�u_" An e7.,Tjoym-is defined as"an individual,parfnatsbip,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enicrprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partner-ship,association or other legal entity,employing employers. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelIing house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or budding appurtenant thereto shaIl not becanse of such employment be deemed to be an employer." M&L,chapter 152,§25C(t7 also sites that"every st2te or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for airy applicaant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neithrx the comic,onw'eatth nor gay of its political subdivisions shall enter mti any contract for the performance ofpubho work until acceptable evidence of compliance with the in=an ce._ requn-e nieutsofthischapterhavebeenpresentadtothecontractingavfhodty." Applican-ts : Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sob-contractors)name(s), address(es)and phone numbers)along with their cer6frate(s)of hasura ce. Limited LiabrMty Companies(LLC)or Limited Liabdity.Partnerships(LLP)v ith no employees other than the members or parine-s,are not regrm-ed to taffy workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for conformation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be retmmed to the city or town that the application for the permit or license is being requested,not the Department of hxh'T cfT'i al A coiden-ts. Should you have any questions regwdmg the law or if you are required to obtain a workers' compsation policy,please call the Department at the number listed below. Self-insured companies should enter their en self-filsura ce license n=bar on the appropriate line. City or Town Officials Please be sti a that the affidavit is complete and primed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple pennhEcense applications in any given year,need only submit one affidavit mdicaiing current policy information(if necessary)and under"Job Site Address"the applicant shoT�Id write"all locations in (city or town)"A copy of the-affidavit that has been officially stamped or maimed by the city or town may be provided to the applicant as proof that a valid affidavit is on file for fislnre permits or licenses A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permitnot related to any business or commercial venture (i_e_ a dog license or permit to burn leaves etc.)said person is NOT regoired to complete this affidavit The Office of Invmfjgations would like to thank you is advance for your cooperation and should you have any questions, please do not hesitate to give us a Call- The,Departmenf's address,telephone and fax number. -Tht C�ommcnwealtIl of Massaclhu&�tts Depadmmt of Iiadustial Accidenta office of jve&fintiow� 6�4- tan t Bostauz MA G I l l ToL 4 617'27-49QO�xt 4-06 or I-9 MA-SSAFF, Fax#617-727-7M Revised 4-24-07 mas! g din w F�r snaxsTnsi,€ MASS. Town of Barnstable AtFp�� Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO j Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 5.08-790-6230 Property Owner Must Complete and Sign This Section. If Using A Builder as Owner of the subject property hereby authorize alIzr.Q < < �` -. to act on my behalf, a in all matters relative to work authorized by this building permit application for: (Address of Job) /l Signature of Owner /✓ Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. 'Q:\WPFILES\FORMS\building permit formsMPRESS.doc Revised 040215 Town of Barnstable Regulatory Services r. THB rqk� Richard V.Scali,Director Building Division snRrrsxnsrE Tom Perry,Building Commissioner V, 1 .19. ��� 200 Main Street, Hyannis,MA 02601 ArFD" www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# . CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be;-.a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures.'A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. `� The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner t Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION V The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\FMRESS.doc Revised 040215 n ^� =gib ; b t i ,311 34 = 5 TIG s -- M _. w/1[[ -•:it/tta ;' [YfF` License e �agistn ion 4 it[t i€ for individul use on ij ?t-tice t;f}nsnpner A(iii3 s&Rus tIacks Ru iilation p E JNi IMPROVEMENT CONTRACTORbe€=re the pi€i=# ?$date- if tot nd rrt€siP to: Office of c onstim Ufa€ s and Business Oegulaiinn Qgiatrat€on ;7780 YyR =� '. Indly dUuai lfa k ' z a i._�.51170 pint=; I20 Eh_ B : MA 0211 � T JAMES Q'UIGLEY JA livIES Qi3IGLEY (4+l,ASHREE.IMA 02649 ,idea Nut valid without a u e R � a ems , Town of Barnstable *Permit Expires 6 nths rom iss e �s Regulatory Services Fee • RAM MMEX 9� MASS.1639. Richard V.Scali,Interim Director �� Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town..barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number PE , Property Address Ule� W11 esidential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address \41"l .442 4e :.. ��•' Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) /'7��p� Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: I am a sole proprietor MAY 2 7 20% ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name TOWN Or BARNSTABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate.must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping•old shingles) All construction debris will be taken toK� ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) EVRe-side O-Replacement Windows/doors/sliders.U-Value 3.� (maximum.35)#of windows 7 #of doors: C) ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is,. A-1 required. SIGNATURE: �---= QAWPFILESTORMS 'ding permit forms\EXPRESS.doC Revised 061313 f ----- - ------ The.Commonwealth of Massachusetts Department of IndustrialAccidents Ofce of Investigations ' r 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers Applicant Information Please Print Legibly Name(Business/OTanizatiowhdividual): 3 f LJ/ Address: , 91warI ly r s City/State/Zip: Ccs eo��/ Phone#: lJ �' e � �!� Are you an employer?Che&the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I 6. ❑New constriction - e;n loyees(full and/or part-time).* have hired the sub-contractors 2.L�'I am a sole proprietor or parer- listed on the attached sheet 7. [�e odeling ship and have no employees These sub-contractors have 8. Demolition workingfor me in capacity. employees and have workers' any ap ty. 9. ❑Building addition [No workers' comp.insurance comp.ins„rance.I required.] 5. [] We are a corporation and its 10_❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also Ell out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such. $contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: ' Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a . fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DU for insurance coverage verification. I do hereby certify under the pains and penalties ofperjury that the information provided above is true an correct Signature: Date: �Z Phone#: - Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 1-Building Department 3.City/Town CIerk 4,Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: P Information and Instructions . Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in'a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the perfoffiance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call.the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions.- please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Qfflcp,of%yestigations 600 washin4on.Streefi. Boston,MA 02111 TPA.#f 17-727-4900 ext 406 or 1- TMASSAFE Revised 4-24-07 Fax#f 17-727-7749. WwwMass.gov/dia - - ---- - --... iI ✓ _ ° `"ET° ti Town of Barnstable , Regulatory Services t BUS&IE$ Richard V.Scali,Interim Director Eo;u,�k�0 Building Division Tom Perry,Building Commissioner 2001Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Ovhier Must Complete.and Sign This Section If Using A Builder r c�_ 0�P !� `-'� ,as Owner of the subject ptoperty hereby authorize to act on my behalf, in all mattets relative to work authorized by this building permit 4121 ,(Address of Job) *Pool fences and alarms ate the responsibility of the applicant. Pools are not to be filled or.utilized before fence is installed and all final inspections are performed and accepted. Signatute of Owner tote of Applicant . Print Name Print Natne 4-7 D e Town of Barnstable - Regulatory Services r t1KE Tqk� Richard V.Scali,Interim Director Building Division "Misr LFc Tom Perry,Building Commissioner 9� 1163 ��� 200 Main Street, Hyannis,MA 02601 �Ea MAC www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6250 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB-LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends foreside,on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such`use•and/or farm structures.`A person who,constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"hom owner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 1091.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall,act as supervisor. t %� Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,.particularly when the homeowner hires unlicensed persons. In this case;our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen-isor License: CS-043084 JAMES J QUIGLEY 8 MARINERS LANE► MASHPEE MA 02649 a 1 a Expiration Commissioner 09109l2014 i . : ,+.,..-q+.lr+ -»-.>.�..�.,.., x-..:...«.:..,..o:..:(.r�.,..�..wa+raj..-.ww..nittr.....n..u....,..,.:m/.:..._.�......ee aw...w.....,.,,....,�.�«.,..-.,e.+w«x«iw..::a+wm2.n..*^.✓.+:w'.Y.w:..„®.e;:.as�revwu..mrwws=.w....o......uv�.-nar...,v-..:....�...d.,,.�.., Office of Consumer Affairs&Busibess Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: registration: 177807 Type: Office of Consumer Affairs and Business Regulation expiration 2l10l2016 Individual 10 Park Plaza-Suite 5170 �.,., Boston,MA 02116 JAMES QUIGLEY JAMES QUIGLEY t 8 MARINERS LN. g MASHPEE,MA 02649 Undersecretary Not valid without sige ure ' d ' i ,E Town of Barnstable *Permit# � SWS l :Y Expires 6 months from issue date Regulatory Services Fee % BJARNsrna[.E,KAM t 16yg. 0� Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 ` www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Q55 /4t5L_5 Property Address r p / "[Residential Value of Work$ ,UD Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address / w /lzet Contractor's Name Telephone Number g—y/7 -7 ' Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) om+ ❑Workman's Compensation Insurance ~P• ,RCS Check one:. S �6RNj/r ❑ I am a sole proprietor �am the Homeowner JUL ��, ��13 ❑ I have Worker's.Compensation Insurance Insurance Company Name WN �d D� Workman's Comp.Policy# vSTAe�� Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) O-Re-side [Replacement Windows/doors/sliders.U-Value 0. 3 (maximum .35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: QAWPFILESTORMS\buildingpermit forms\EXPRESS.doc Revised 061313 the Commanweakh of Massacknsetts i gwhnent of lrrdaatrial Accid Office of Inmfigadons 60013rashuegton Stmet Boston,MA 02111 rwrvku»t gov1d a Workers' Compensation Insurance Affidavit:BBmiders/Cun ' ians(Plambers Applicant Information Please Print Le t'bly Nam Address: C--) _- �'�74�,, city/St C , phone,4-- Are you an employer?Check the appropriate boa,: Type of project(required): 1.❑ I am a employer with 4. ❑ I am:a gmeral.contractor and 1 6. ❑New . employees(fu11 atWor part-time).* have hired the sub-�aas 2.❑ I am a sole proprietor or-partner- listed an the attached sheet. 7. E5-FJemodeling ship and have no employees These sub-o0ntraclors have 8. ❑Demolition woddng forme in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance.1 9• ❑Building addition ' required.] 5. ❑ We.are a corporation and its 10.❑Electrical repairs or additions 3.IT,am a homeowtber doing all work officers have emercised their I LE]Plumbing repairs or additions myself [No worla n'commp. right2 lemmgdon perL 12..❑Roofrepairs insurance required. C.] employees- o workers' 13.❑Other comp.insurance required-] *'Auy zpPbc=dot checks box#1 mast also till out the:section belaw showing the¢woakeas'camapea�sation Percy inforanvtirm I Hmmeowners who subunit this iffibrvc m&cMmy,they are doing all w ak and then hue oaWde conuactors mast submit a new affidavit indicating such lconmctors that quail[this boat mast attached=additianal sheet showing the mme of the sub-ccmtrscom md:state wheth or not those eauties have employees. If the sub caastiactots ham employees,ffiey mustpmvide their workers'comp.Policy number. I am art eutplgywr that isprni&W workers'compeasaficn insurance for my employees. Below is the policy 0 d job sits informadam Insurance Company Name- Policy#or Self-inYs..Lic.#: Fxpiratio Date: I, Job Site Address: City/State/Zip: I Attach a copy of the workers'compensation.policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required.under Section 25A,of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be:advised that a copy of this statement may be forwarded to.the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerhf3�under the pants and penabyes ofpt£rjury fhatthe ittforMditart.prasi&d above is bue and c7orrect Si Date: Phone#: i!!!5 G 7 =LG O,o`t-W use only.. Do not eFrtte in this area,to be completed by idty or town official City or Town: PermitlLicense# Issuing Authority(circle one):. 1.Board of Health 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6:Other Contact Person: Phone#: 6 T Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry,Building.Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 509-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: ` a JOB LOC, ON: i nurd6 sired village "HOMEOWNER": ��� S' /f�.. 61 9y� name home phone# work phone# CURRENT MAILING ADDRESS: cityADwn state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form i acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,. bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection proce es and require nts and that he/she will comply with said procedures and requirements. Si slime of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix.Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons..In this case,our Board cannot proceed against the unlicensed I person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is My aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decolldc\AppData\Local\Microsoft\Rrmdows\Temporary Internet Files\ContentOutlook\QRE6ZUBN\EXPRFSS.doc Revised 053012 oFTME Town of Barnstable ,�.. t Regulatory Services t RARNCPA21M ! •' Huss Thomas F.Geiler,Director 1639 h� �p Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder- as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) *Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature.of Owner Signature of Applicant Print Name Print Name Date QIORMS:OWNERPERMISSIONPOOLS 62012 114E � Town of Barnstable Regulatory Services • BARNSTABLE, MASS, Thomas F. Geiler,Director i639. �0 , 039 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 July 10, 2013 Vera Lee Sullivan 130 Mylod Street Norwood, MA. 02062 RE: 24 Forsyth Court, Cotuit, MA, Ma 055 Parcel 059 Yt p Dear Property Owner: In accordance with 780 CMR R113.2 you are notified that you are in violation of 780 CMR R105.1 and a stop work order has been posted. On or about July 9, 2013 this office observed new windows and siding in the process of being installed at the above- referenced address without the benefit of a building permit. Please arrange for the property to be,brought into compliance immediately. Thank you for your anticipated cooperation in this matter. You may contact me at(508)862-4034 with any questions. By Order, 4e Lon Local Inspector (508) 862-4034 jeffrey.lauzon@town.bamstable.ma.us TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map dS'.�' Parcel'. 9 Application # CO(60CJ3* Health Division Date Issued �t'O Conservation Division '_� Application Fee pl? - � Planning Dept. Permit Fe Date Definitive Plan Approved by Planning Board D Q u Historic - OKH _ Preservation / Hyannis "Q RECO AUG 3 Project Street Address a24 0 CoLIRT =55;�J Village MA ; Owner MAVf I Gul<ljmq Address_ WX AS 48ovC Telephone Co j!7 - 0 GA - _777 f_3 Permit Request fi�v��U( (��t..) I S �.�1�DQ —J&f as '02e 0 5AJU R=! 1300 39(o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new 34� Zoning District R F Flood Plain NO Groundwater Overlay Project Valuation �10 OW- aO Construction Type h\elj lA)0o"'b C dvS olJ Lot Size 1.13 AC12g:5 -t- - Grandfathered: ❑Yes ❑ No If yes,attach supporting documentation. Dwelling Type: Single Family Q/ Two Family ❑ Multi-Family (# units) Age of Existing Structure 30 Historic House: ❑Yes Xo On Old King's Highway: ❑Yes CTNo Basement Type: 0/Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) — 0 - Basement Unfinished Area(sq.ft) Number of Baths: Full: existing�a _ new "a Half: existing 'P new Number of Bedrooms: 4 existing 0 new Total Room Count (not including baths): existing 9 new 1 First Floor Room Count � Heat Type and Fuel: C1 Gas ❑ Oil ❑ Electric ❑ Other Central Air: C/Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes CTNo Detached garage: ❑3/existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: 5/existing ❑ new size _Shed: ❑ existing ❑ new size A Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use 644ti.0 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ?4u L ► 4,2 2-u LA- Name ='A_t1_ Telephone Number Address (P44 '2 y-fA 12D License # e s " S 7934 fbAU40P ✓Yl#11 J Home Improvement Contractor# I5a A53 Worker's Compensation # 14C ALL CONSTRUCTION BRIS RES��e6- 6 THIS PROJECT WILL BE TAKEN TO w UIv r� G� SIGNATUR DATE 4 FOR OFFICIAL USE ONLY „APPLICATION# DATE,ISSUED 1 z MAP/PARCEL N0._ , t ADDRESS. VILLAGE OWNER DATE OF INSPECTION: 2- 7— / tz :FOUNDATION-!' a!�� . t FRAME Cp 117,1111 FiW 2 o a RAC4— sr�aY 1 LA NSU�LATION''f<A/S SG zA,,y « ,e --�,,,n - + FIREPLACE t ELECTRICAL: ROUGH FINAL w PLUMBING: ROUGH FINAL r pH GAS- 4{ F ;ROUGH ^`U— ;dif` FINAL { Q,41FJNAL BGILD'ING n :5: DATE CLOSED OUT s ` ASSOCIATION PLAN NO. z t r To� n of Barnstable of Regulatory 5endces Thomas F. Geiler, l�ixector • t HASi113TA�i�. .. . Building Division Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA- 02601 www.town.banutable.ma-us ' r Fax: 508-790-6230 'Office( 508-862-4038 PLAN REV-JEW. Owner: �3U-L,4VA4 Map/Parcel: O Ss O 9 a 7 FORS 1� �,c Builder: �s ,' I�r•S . Project Address The following iterns were noted on reviewing: Reviewed by: Date: • I - The Commonwealth of Massachusetts Y — Department ofIndustrialAccidents -,Office of Investigations 600 Washington Street t Boston, MA 02111 �- www,Mass.gou/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): C�� �[il�ta(�2S ��� P40L M4Z2_ LA- Address: (6 44 fSox S-01 1l' . City/StatdZip: �I�,��i1,.1 1 1�4' �ho.he#: S . . 7for 40 91 Are ou an employer?-Check the appropriate box: Type of project(required): ]. I am a employer with 4 _ 4. ❑ I am a general contractor and I 6. ❑ New construction * have'hired the sub-contractors.. employees'(fu1J and/of part-time). -- -E]Remodeling ning 2.❑ I am a sole proprietor.or partner- listed on the attached sheet. 7. ship and have no employees These sub-contractors have g• ❑ Demolition workingfor me in an ca aci employees and have workers' Y P �'• 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their ' 11.0 Plumbing repairs or additions myself. [No workers'. comp right of exemption per MOL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 1.3.❑ Other comp.insurance required.] *Any applicant that checks box If l must also fill out the section below showing theirworkers'compensation policy information. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contrantors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job'site information Insurance. Company Name: Qalowd_ (o-rf�•��tOQ` �� '� S��CT Policy# or Self-ins.Lic..#: e-46t) a3774 Expiration Date: S a8 Job.Site Address: rP4 z6y cr)UQ 1 City/State/Zip: No / 94 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MOL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year risonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day gga' t e violator, Be,advised that a copy of this statement may be forwarded to the Ofzce of Investigations of the for insurance erage verification. I do hereby cer under the pai and penalties ofperjury that the information provided above is true and correct. jfSk Signature: ,/G M Phone#' —0Dn `774 —44% 1 ��/L �'14-L2-01.* Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority (circle one): , 1. Board of Health 2. Building Department 3• City/Town Clerk 4. Electrical Inspector S,rPlumbing Inspector 6. Other Contact Person: Phone 4: e Massachusetts General Laws chapter 152 requires a)) employers to provide workers' compe•nsalion for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." r An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of.the foregoing engaged in ajoint enterprise, and including (he legal representatives of a deceased employ er, the or t receiver or trustee of,a❑ individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more [ban'1hiee apartments and who resides therein, an or the occupant of the dwelling house of another who employs persons to co maintenance, cons tniclion or repair work on such dwelling house or on the rounds or building eppurtenaot thereto shall not because of such employmen-t be deemed to be an emp)oyer." g t kk ♦ r MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall iv,ithhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for I ,Y applicant who has not produced acceptable evidence of compliance with the insurance coverage required•'.' Additionally,MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for theperforrnance of public-work until acceptable evidence of compliance with the insurance requirements of this chapter have beenpresented to tl:;e contracting authority." Applicants Please fill out.tbe workers' compensation affdavit completely, by checking the boxes that apply to your siR)ation and, if necessary,supply sub-con[raetor(s)narne(s), address(es)and phone numbers)along with their certificate(s) of insurance, Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers" compensation insurance. if an LLC or LLP does have employees, a policy is required. Be advised that this affidavil may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date th•e affidavit, The affidavit should be returned to the city or [own Lhat•the application for GIe permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you.are required to obtain a,workers' compensation policy,please call the Department at the number listed below, Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials •1 t Please be wire that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the afdwvit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a.reference number. In addition,an applicant a" given ear, need only subrnit one affidavit indicating current e it/license a hCatinns rn n y , Y that must submit multiple,p rm pp Y g r P (city o Policy information(if necessary)and under"Job Site Address" the applicant should wale aJ1 locations�n town)."'A copy of the affidavit that has been off cially stamped or marked by the city or to maY be provid e d to the applicant as proof that a valid affdavit is on file for future permits or licenses. Anew affidavi lIT be filled out each year. Where a home owner or citizen is obtaining a license orpennitnot related to any businesslo commercial venture (i,e. a dog license or permit to bum leaves etc,) said person is NOT required to complete this aid The Office of lnvesligahons wou "ke 0 . lzn ymm�aa� rnnnrratinn and shou➢d youhave any questions, please do not hesitate to give us a call. The Department's address, telephonck and fax number: The Commonwealth of Massachusetts 'Department of Industrial Accidents Office of Iny'estigations 600 Washington Street Boston, MA 02111 Tel. # 617'727-4900 ext 406 or 1-8777MASSAFE Fax # 617-127-7749 Revised 4-24-07 www.mass.gov/dia /16/2010 MON 13: 17 FAX 15087901677 FAIR INS 0003/004 ` ACORD ATE(MMlDD/YYYY) rm , CERTIFICATE OF LIABILITY INSURANCE Dos/16/m10 PRODUCER (508)775-3131 FAX (5O8)790-1677 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Fair Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.O. Box 430 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, 619 Main St. Centerville, MA 02632 INSURERS AFFORDING COVERAGE NAIC# INSURED The Waquoit Group LLC DBA GCI Bui 1dare, Inc. INSURERA: National Grange PO BOX 509 INSURERS: Savers Marstons Mills, MA 02648 INSURER INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I 6R DD' TYPE OF INSURANCE POUCY NUMBER~ POLICY MIDDtY NE POLICY E IDDIAT'10N LIMITS LTR NSR DATE MMlDDIYYYY DATE MMlDpIYYYY GENERAL LIABILITY MP143707 O5/28/2010 O5/28/2011 EACHOCCURRENCE $ i,000,0DO N MERCIAL GENERAL LIABILITY 7�MAZ`ETURER1'ED $ 5O OOO _ PREMISES(Ea occurrence} , CLAIMS MADE LAj OCCUR MED EXP(Anyone person) S_ 5 OOO A PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE $��2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY PRO_ LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS I BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS 80DILY INJURY $ NON-OWNED AUTOS (Per accident) _ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE u. $ RETENTION $ $ WORKERS COMPENSATION WC0002374 05/28/2010 O5/28/2011 70RY LAIMI7S AND EMPLOYERS'LIABILITY ER B ANY OFFICERIMEM ER EXCLUDED?ECUTIVEa E.L.EACH ACCIDENT $ 100,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 10(),00 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 15 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Mr. & Mrs. Sullivan REPRESENTATIVES. F�Klathy UTHORIZED REPRESENTATIVE 24 Forsythe Court �( n• Co uit, MA 02635 Silvia FAI3S1 ACORD 25(2009101) 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD r HIC Registration Complaints Page 1 of 1 s. . The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Mass.Gov Consumer Affairs and Business Regulation Home> Consumer> Housing Information > Home Improvement Contractor Program > HIC Registration Complaints Registration# 152253 Registrant GCI BUILDERS INC Name PAUL MAZZOLA Address PO BOX 509 City,State,Zip MARSTONS MILLS,MA,02648 Expiration Date 8/11/2012 Status Current No complaints found forZthisgistrant. You can also view arbitrnd Guarant Fu histor Back To Search ©2010 Commonwealth of Massachusetts P http://db.state.ma.us/homeimprovement/licdetails.asp?txtSearchLN=53360 8/30/2010 t�y.tcituoett:r- Department r#f Pttf�lic ' ttt(I of 6Utftttn=r R cr ,+ 4 c;ruf;t�'t+�na jtttU _. -Gohstructton Supervtor Lten$ s �e tense: 57934 Siestricted to. 1 G fi `y PAUL J .MAZZOLA PO BOX 509 MARSTONS MILLS,.MA,02648� a Expiration: &19/261 i , 4�1711iitASH�III 4'zw:. ; Tom. 1 .4" r_ 7589,� a r BOR tog r� t16 9ti Ys p H lVtE'f10PROVEMENT CONTRACT©f2 �p Registratson ,152253 a. EXptra>ton 8141/2010 Tr# 276039 s Type: Pc�vte Corporation j GC`f3l1ILDERS } PAUL'MAZZOLA 644 RIVER ROAD , { T(?NS MILLS,MA,0'94- Aclmiki`r�txatnr V*r Town' of Barnstable Regulatory Services t x,taxsrABLE, : . ' Rues. $ Thomas F. Geiler,Director .Building Division Tom Perry,Br ilding Comrnissioner „. 200 Main Street,Hyannis; MA 02601 www.t6wn.barnstable.ma.us a Office: 508-862-4038 " Fax::S09-790-6230 Property Owner Must Complete and Sign.This Section If Using ABuilder ti C ek--, , as Owner of the subject property hereby authorize �";��.e �e—,,5 to act on my behalf, in all matters relative to work authoriied by this building permit application for. ssy.of Job) y FN Signature of er Date '4 Pant Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form:on the reverse side. Q:FORMS b WNERPEW ISSION Town of Barnstable {; ' Regulatory Services Thomas F. Geiler,Director xiwss. Building Division �PrEn!�j F d Tom Perry,Building Commissioner 200 Main-Street,_Hyannis, MA_02601 R wtv.town.barnstable-ma.us Office: 508-862-4038 Fax: 508-790-6230 Ef O LEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name, home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code Ae current exemption for"homeowners"was exten to inclu owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire w o doe of possess a license,provided that the owner acts as supervisor. DEFINrrION OP OMEOSi NER Persons)who owns a parcel of land on which he/she resi s o intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached s ctures ecessory to such use and/or farm structures. A person who constrticts more than'one home in a two-ye period s not be considered a homeowner. Such "homeowner"shall submit to the Building Official o a form acceptor e to the Building Official, that he/she shall be responsible for all such work performed under the b ding Pernik (Se 'on 109.1.1) The undersigned"homeowner"assumes respo ility for compliance with e State Building Code and other applicable codes, bylaws,rules and regulatio The undersigned "homeowner"certifies t.be/she understands the Town of Barns ble Building Department minimum inspection procedures and r irements and that he/she will comply with s procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three- y dwellings containing 35,000 cubic feet or larger will be required to compl with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that "Any bomcowncr performing work for which a building permit is required shall be exempt from the provisions of this scction.(Scetion I D9.1.1 -Licensing of construction Supervisors);provided that if the homcovmcr argagcs a person(s)for hire to do such work, that such Homeowner shall act as supa-visor." Many homeowners who use this Exemption an unaware that they an assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness bfirn rtsults in serious problems,particularly when the homeowner hires unlicensed pusons. In this case,our Board cannot procccd against the unlicensed person u it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimate)y responsible. To ensure that the homeowner is fully aware of his/her responnbilitirs,many communities require,as part of the permit application., that the homcowncr certify that hdshe understands the re-sponnbilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/ccrtification for use in your corrununity. Q:forrrrs:homacxcmpt h . J Land in BARNSTABLE Belonging to William E.&Mary F.Alexander Deed in Book 2588 Page 273 Land Court Certificate No. in Book Page In Barnstable Registry of Deeds Recorded Plan "Cotuit Bay Shores",by Garcia,Hanack&Richard,Engineers&Surveyors Date of Plan January 1975 in Barnstable Registry of Deeds Plan Book 292 No. 25 et seq. Filed Plan No. MORTGAGE INSPECTION PLAN Maurice H. Sullivan,Jr., P.C. Loan No. 24 Forsyth Court,Cotuit 82, lSU.' Lob 46 �3 i� x/ J r I.P.fnd. 3 g �J. dC� iVYY7(i� t� 00 � 1 "SEE REMARKS Nov.5, 2002 JN 73390 Scale: V= 50.' JOB TAYLOR DESIGN ASSOC., INC. SHEET NO. OF P.O. Box 1313 Forestdale, MA 02644 CALCULATED Gr T DATE. 7773 "1 C Tel./Fax: (508) 790-4686 _ CHECKED BY Z4 -T 6� -r o SCALE PL r�r . ..... ;....... �• 3 � . . . . 3arz _ .. CL .... fc °17h -tj•�):.. .. .;. ... ...__ . . .. ............... .. .... ,. r ..._. ........................................ .... _ ci .... .................. .%,,.. 4l. n r, Z . .... .. _ ... to c— ... :... .. __ ... ;......... .... ... .._... .._..-. _.i...... .... ..... .. _ ..... .. __-. J06 C-M4 ~ TAYLOR DESIGN ASSOC., INC. SHEET NO. � OF P.O. Box 1313 Forestdale, MA 02644 CALCULATED BY C"� '� DATE Tel./Fax: (508) 790-4686 nn J_""�� CHECKED BY DATE (200-IL-r '� SCALE ..... ......... Aj . go ..... .. ...... ........ .......... _.. 1.. ck 60#7 8 .... .. I tit qa®Ps+ g .99c rr. ,�... .. ...... ''.......7.. _ Cr. +( ;t.. 2.. ....n.. Ca a-- b Z .... _ .Rzfl .... 13 ` r�L-M C z,�C'a o of G• JOB L TAYLOR DESIGN ASSOC., INC. SHEET NO. 2AS OF 4— P.O. Box 1313 Forestdale, MA 02644 CALCULATED BY CV 'r DATE Tel./Fax: (508) 790-4686 CHECKED BY DATE SCALE .............. ...... ..... ............ ........................................ ............... ........... ....................... ....... .............. ... ..... .... ............................. ......................... ........... ........... .......... ................. ...................................... .......-------- .......... ............ ............ .......... ...... ................ ........... ..... ...... ............................ .......... ............. ........... . ................... .......... ............. .................................... ............. ............- .......... ........... ................... .......... t .. ......... ........... ............ ..............- .......................... .............. ........................... ............ .......... .................. X k42 M-0 ............ ............. ................. .............. .............. ............. ...................... ....... .............. ............................ rr T4..ALS.'( I-[ ............................ .......... ............. .......................................................... ............ ...... ........................ .... ............ . .................- C. L • ........................................ ......................... .......... ............. .......... ............ .......... ............ ............... ......... 1..... ...................... ....... .......... ..........1 ................ Z' ................. ................................ ....................................... ........... ............- ....... .3 4 ............ .......- ..............S7 . .........J ...........p................... ...................... ........... ..........- . ....... ........... SAS—4 60 ... . . ............................. ........................... ....................... ................................ tv .......... .......... ........ ... .......................... ................ .............. .... .................... .............- .................... ............... .......... .......... ....... ........................ ........................... ........... *24 �75 ............. .................................... ...... ..... ..............-.............. .......... i 0'QQ'! 00e '00".00""o ........... ......................... .......... .......... .......... ...... ...................... —r—IrL.Y N4 1k ................................ ........... .................... 50 . ..................... . ......... .. ......... t4-- .................................. .......................................-------------........... .......................... ----------- 24mo, ....................... 4 .......... .............----------- . ......... J. JOB �Tr.►t��:.::�: � F�� TAYLOR DESIGN ASSOC., INC. SHEET NO. � OF 4- P.O. Box 1313 � Forestdale, MA 02644 CALCULATED BY CT 'r DATE 7—S— 140 Tel./Fax: (508) 790-4686 CHECKED BY DATE �#. t T SCALE ... ... .... ........_ ............. , . etw Z X 10 ,e Lt .._a G,. ._.. . .... .. �v +gyp toy caws wac.c. .. Z' N4 �r ..... C- � Z O .... T[f .. ...... kok� � vp a $ ... . . . . ... :.. f . ". Telephone: 508/563-6049 COLONY INSULATION, INC. 28 Jonathan Bourne Drive, Pocasset, MA 02559 CLOSED-CELL FOAM INSULATION SPEC SHEET CONTRACTOR: , JOB SITE ADDRESS: 6—sv' \ DATE: .�• �• AREA THICKNESS R-V:ACUE Ceiling QQ athedral Ceiling sO , Garage e� ing Basement Ceiling Slopes Exterior W all Large Hse. Wall Walkout Wall Cathedral W all B lockers Overhang 1 Stair/Risers ^"-- YJf rn o y' All R-values and thickness measurements are deemed to be accurate by the following installers: TECHNICAL DATA FOR MATERIALS IS ATTACHED TO THIS FORM . r ThermoSeaC 2000—Product Specification ASTM D2856 >=90% Viscosity& Weights `. `. ASTM D2196 Viscosity A Side ISO @ 70°F 215±35 B Side Resin @ 700 F 700f 100 ASTM D1475 Weight/Gallon Spr A Side ISO @ 770F 10.2lbs p0 Box 1182 B Side Resin @ 770F 9.8lbs New Canaan, CT. 06840 Mixing Ratio By Volume Phone&Fax: 800.853.1577 ThermoSeal 2000 is a standard 1:1 mix http:///www.SprayFoamPolymers.com product.Slightly off ratio can produce slightly heavier odors and foam characteristics.Typically a heavier A ratio will produce a crunchier foam result,and a heavier B Side ratio will produce a spongier result. Electrical Wiring ThermoSeal 2000 is chemically compatible Suggested Preparation &Use with all 14/3, 12/2 and other similarly ThermoSeal 2000 will perform best when coated electrical wirings.For knob and tube gradually climate controlled to 77°F the wiring please seek the approval of your night before application.While local building inspector. recirculation of ThermoSeal 2000 without Product Storage heat prior to each days spraying is Component A-550 Ibs of Isocynate stored in a a 55 gJ111on contai eT outl d above. suggested,recirculation of ThermoSeal d, Bacterial and Fungal Evaluation 2000 in order to rapidly heat the product is ComPori nt:`A' must b prote�t�d from ThermoSeal 2000 is not a source of food not is not suggested and may result in a freezing trr deemed us�SS. ZZ Co for mold,insects or rodents.It has no decrease in catalyst count and product ' nutritional value.ThermoSeal 2000 reduces yield.We suggest starting with a Component B-SOO Ib ThermSoSeal 2000 the introduction of moisture,food,and temperature of 125°F and a working proprietary formulated resin Component mold spores into the building envelope pressure of 1000 psi. `B'must b e stored been 55°:F and 807 significantly more than traditional never excee'dmg either extreme, insulation such as fiberglass,cellulose and 0 other non-sealants which do not provide an Both components temraturresshould be at air barrier. Product Availabilitv 75°F prior to mixing and use. Contact Spray Foam Polymers at WARRANTY Environment/Health/Safety 1.800.853.1577 for sales and availability When installed properly be a Spray Foam ThermoSeal 2000 contains no CFC's options.. HCFC's,formaldehyde,or volatile organic Polymers authorized representative who has compounds.Following installation there Paeka inja completed all training offered by SFP,SFP will be a 24-48 hour occupancy window warrants that the product will meet all p Y Products are shipped in 55 gallon open top product specifications outlined in this before the odors,emissions and gasses have steel drums.At the customers request the specification document. dissipated'to a habitable level for products may be shipped in 55 gallons open individuals highly sensitive to the materials top semi-clear plastic resin drums. installed. ThermoSeal 2000 is is not to be installed within 2"of heat emitting surfaces where heat dissipated exceeds 1857. DISCLAIMER:Information contained herein is,true and accurate,but all recommendations or suggestions are made without guarantee.Spray Foam Polymers,LLC(SFP)products are intended for sale to industrial and commercial customers.Since SFP exercises no control over its customers appreciation or use of the product manufactured by SFP and since materials used with the products may vary,it is understood that SFP can warrant only that our products will meet our written specifications.Nothing herein shall constitute any warranty of merchantability or fitness,nor is protection from any law or patent to be inferred.ThermoSeal must be installed in accordance with all applicable building codes and a building inspector's approval should be requested prior to installation.All patent rights are reserved.SFP requests that customers inspect and test our products before use,and satisfy themselves as to contents and suitability.The exclusive remedy for all proven claims is replacement ofour materials and in no event shall SFP be liable for any consequential,incidental,indirect,or special damages resulting in any manner from the furnishing of the material. 9jherm,oSeaC 2000—Product Specification Air Permeance/Air Barrier ThermoSeal 2000 fills any shape cavity Burn Characteristics including all voids,cracks,and crevices ThermoSeal 2000 will be cpnsumed by Spr,_ )"g adhering to multiple substrates such as flame but will not sustain flame upon wood,metal,and concrete creating a removal of the flame source.ThermoSeal JhermoSeaC2000 system with very little air permeance.With 2000 will not melt or drip.ThermoSeal ThermoSeal 2000 no additional interior or 2000 must be installed in accordance with Product Specification exterior air infiltration protection is all applicable building codes and a building required. inspectors approval should be requested Product Narne:. prior to installation. ThermoSeal 2000 is the registered ASTM E283 Air Leakage trademark of SprayFoamPolymers.com for Zero(0) f0/s.ft2 @ 75Pa(25mph wind) ASTM E84 Surface Burning Properties its 2.Olb high density,closed cell foam Sustained Wind Load Flame Spread @5" <=25 insulation: Smoke Developed @ 5" <=450 60 minutes@1000 Pa(90mph wind) Class I rating Product Description TBD Fuel Contribution none partially ASTM 2863 Oxygen Index TBD% ThermoSeal 2000 is a semi-rigid;p y Gust Wind Load Test water blown,2.Olb high density @3000 Pa(160 mph wind) VOC TESTING polyurethane foam insulation system blown .TBD CAN/ULC-S774 Pass by Enovate®blowing agent and water SASKATCHEWAN RESEARCH which simultaneously insulates and air- ThermoSealTM 2.0 qualifies as an air barrier COUNCIL seals your building structure. ThermoSeal as defined by ICC. 2000 is designed to make homes more ThermoSeal 2000 must be covered by an energy efficient,stronger,healthier,quieter roved 15 minute thermal barrier or and more comfortable.ThermoSeal 2000 is Water Vapor Permeance a pp applied as a liquid spray which expands ThermoSeal 2000 is water vapor permeable ignition barrier, approximately 15 times its initial mass and and will allow structural moisture to escape. A These flame-spread ratiiigsage not--a cures within seconds into a semi-rigid mass. For situations requiring a vapor barrier the intended'to refl�a hazards prey nted�this i , F_, ThermoSeal 2000 fills all building cavities use of low vapor permeable paint on the or any other material under actual firms completely sealing all cracks,crevices,and interior of drywall is an option. conditions. cr" . —n voids where air loss and infiltration are .„„ Water Vapor Transmission Properties: ��,r most common. Compressive and Tensile'Sreni ASTM E96 data ThermoSeal 2000 his favorable Technical Data' compressive and Tensile strengHt prop ies Water Absorption for high density foam. l�-? 03 rn Thermal Performance ThermoSeal 2000 is water repellent,will zn Thermal resistance(aged 180 days)R/in. not wick,and does not exhibit capillary ASTM D 1623 Tensile Strengths i psi ASTM C518: R6.62hr.ft2°FBTU. properties.Water cannot be forced into the ASTM D 1621 Compressive Strength p foam under pressure because of its high Ph sical Characteristics Average insulation contribution in stud degree of closed cell structure X wall: DIMENSIONAL STABILITY 2"x4"=R23 2"x6"=R36 Acoustical Properties Performance in a 2"x 6"wood stud wall. ASTM D—2126 ThermoSeal 2000 provides greater R value 158'F 100% Relative Humidity,7 days performance than other equivalent R value ASTM E413 STC Sound.Transmission Volume Change <8% insulation materials which are air TBD permeable such as fiberglass.ThermoSeal 2000 does not lose R value due to wind, ASTM E 90 Class 33 Closed Cell Content ageing,convection,air infiltration or ThermoSeal 2000 is considered closed cell moisture.An R value fact sheet.is available Funl;i Resistance foam insulation: - _ upon request, ASTM G—21 ZERO RATING DISCLAIMER:information contained herein is,true and accurate,but all recommendations or suggestions are made without guarantee.Spray Foam Polymers,LL:C(SFP)products arc intended for Sale to industrial and commercial customers.Since SFP exercises no control over its customers appreciation or use of the product manufactured by SFP and sinccmaterials used with fitness nor is pro for tect on fromt is any law wror p Ie�,�,Ia�SFP Pm r� �� esl that must products be installedwill in accordance with all specifications. appl cable building codes and athing herein shall constitute any building inspector's warranty approval shop should or requested prior to rcmed inst all provenll pa tentis Beplaemcnt offhts are d.S mateFP rials to t in oha tevennsha inspect SFP be liable for any consequentiallincidental,d satisfy direct,or specialemselves as to tdamages ts and sresultiing in aity.T ny Y for. manner from the furnishing of the material. JOB. My 01114 Alt— TAYLOR DESIGN ASSOC., INC. SHEET NO. OF P.O. Box 1313 Forestdale, MA 02644 CALCULATED BY Gr -r DATE �P— *3 Tel./Fax: .(508) 790-4686 A y CHECKED BY G... T �7 -ro SCALE A IM TA ....... .. n, . . .. ... _. 3 ........................scar.J -r+ . - s _C -�. � -b.:. fit ® s _ .. P . . _ t , __....�G$.rs�!� ._t. �s ....... .:... . c c ►1*1- tit �.pJ ..... .... ... L ... .; t a. '.."'r `t.i . .. t, a.e .. . ...... .............. ............. ...... ..... ........ .......................... ..... ... .... _.... t p. JOB. GYIR tTbJ TAYLOR DESIGN ASSOC., INC. 'SHEET NO. of P.O. Box 1313 Forestdale, MA-02644 CALCULATED BY C�'Y DATE T•�"I Tel./Fax: (508). 790-4686 CHECKED BY DATE SCALE .... ..... O.C� : ... a---�d....40 l d► C Ccrr.�T .. ..... .. ... 10 .. ................. ... ....... ... . IL (Z�. -tl... - Z7� - ,�,car ;_ .. . ... F! �� � � 4�9 .1 • . ........... �.� ,,. ....... '� k1 .... :_..:: _®o..C �._7 �GBB. ..:'� : .. Jam '•. �... . .�.4.. .. :.._ d fs .. CAP .............: . M JOB A-htJva JArt.. �'t TAYLOR DESIGN ASSOC.; INC. SHEET NO. of P.O. Box 1313 Forestdale, MA' 02644 CALCULATED BY DATE 7- 3" Tel./Fax: (508) 790-4686 CHECKED BY DATE • SCALE ...................._.... .. ..... t v . UL { � f ............. L-- c�. ..l.n . mow... 3 l � 4 x l<t._�l� cp ✓ c .j ............................. ....... .... ... . Zoo C 4_ � .........�. .. . 46 r o ..... ti � 1, . e.,,_4 1 C T , . ,. t ti t o I . . S C Viz. ._ B -Cc� �r >� �.— c z� �—5 30 � . L : .. �;..1 d ��®0� ; ® ^ . _ ................ l JOB L TAYLOR DESIGN ASSOC., INC. _. SHEET NO. �-' of P.O. Box 1313 Forestdale, MA 02644 cdLcuLArED 6Y, C? DATE '7— Tel./Fax: (508) 790-4686 CHECKED BY DATE Co t r SCALE ._ 4 1af ul a xlo 9@Lv _cL... .. -1 _ z .....�� s......... ...r'T'.r. ..... __.. ... ........ ................ .... L� Z o`� •( ............ !'.. T�1 v� c. . ..... io tl ....... t �' I4x R _ _4- ...._ . ..... 3t s 4.11 .. ..... .. „ •"'•,. "n ' TOW 'OF BARNSTABLE } 2-1462 Permit No Building Inspector 1 au�xaab r. Cash OCCUPANCY , PERMIT ----� '. Bond No buildng'nor structure shall be.,-erected; and no landbuilding or,structure shall be y used for a new;rdifferent;!c rg hanged, or enlaed use 'without a` Building Permit therefor first having been.obtained from, the-Building-Inspector..No building shall be.occupied until a certificate of occupancy"has,been issued.by 'the''Building Inspector.” �. ;V Issued to l 11 a'�n,&;rMa'ry @X3Y?C1L'Y°/t?�Address� Mel I'os2 s MA. lot. #46 24 Forsyth Court„ Hotvit'1. •- Wiring Inspector �� Inspection date ror r, Plumbing Inspector1 � r �_.. Inspection date Gras Inspector. Inspection,date e/ Engineering Department �7 �j f� �,� ��r, f9! `a Inspection date,:��"`--• '... THIS PERMIT.WILL NOT BE VALID, AND-THE BUILDING SHALL NOT BE OCCUPIED .UNTIL SIGNED BY THE 'BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE' WITH TOWN . REQUIREMENTS:1'6 . (�''} B _ -�ilding Inspector , �T 1 HERE COMES 1� EXECUTIVE OFFICES ❑ ROUTES 3 AND 128—SOUTHEAST EXPRESSWAY ❑ BRAINTREE, MASSACHUSETTS 02184 0 Victor 8-0100 REPLY TO: ROUTE 28 AT AIRPORT HYANNIS, MASS. TEL: 775-2030 �10 Ljl%ovv�� �or�eeet� ; ��- �c,oc1,C 4,0�- 'r)t,I� �\�, C,o, , rec�oc-d► >r,o� �1�ekk �oc a r cl"d U o►e�oc o� 4 �\ d Core M4y i to� , '3•o x (.-I Y. 1'A ecd T %Q M\0k ��Q�QcK`°► - d►ooc'�e��de.���c�.\ �o�a ��nQ4'� ��,�. M4�1 ��� of d► Q U '�Qc�ar -')a\d dooc- \r-s�ok\Qd O� l-C%k '�jocd►c�a ��.e� Qatxk oAm r JJo keS c r`c�dhn'�i 70'h I ANNIVERSARY CEEISRAYIHO 70 YEARS _ SERVICE YO HOSU O IR 1896-19" O V E R 5 5 L U M B E R Y A R D S E V E R Y T H I N G T 0 B U I L D W I T H Assessor's map an I d lot number ...... 114E St-wa6 Permit number ... 1/6-11.. ............. 9 ov— Aa 33A"STABLE, AOR House number ............. ................................... CODE639- TOWN OF BARASTAB BUILDING -INSPECTOR APPLICATION FOR PERMIT TO .. . ...... ?��........................................ TYPEOF CONSTRUCTION ..... ...........klnq! .......................................................................................... .....................J.V.Y. ......../.4?—.1 9.2f.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... .........I............................................. Proposed Use ... .......... ..... .....ev ....... .................................................................... ........ ZoningDistrict ........................................................................Fire District ...Con?, .................................................... Name of Owner ........Address .............................Ng/4!1^. ..ez ............... Name of Builder ................Address .... Name of Architect ................ C .qe< ..........Address .............................vel* .......�..i................. Number of Rooms .....&.........................................................Foundation Kq. wro.........C�� .................. Exlerior 40VA-ea.........s:.AIIVJILO...... .........Roofing ........ ........5'. /Q........................ Floors .0,04e<.....f.......C—00 Interior jR.,11f-S7.-.e1Z-'......................................................... ........................................ Heating ...... .......'Y.........Plumbing ....... ../I;k .... ........................................... Fireplace .....0.,e4..................................................................Approximate Cost ............................. .... Definitive Plan Approved by Planning Board --------------------------------19--------- Area .......................................... Diagram of Lot and Building with Dimensions Fee ......... SUBJECT TO APPROVAL OF BOARD OF HEALTH 00A/0 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... .......... ........... .. ........................ Alexander, William & Mary A=55. -59 ,'No c.214ra.2,... Permit for ..aij19le..fzLmily- ..... dwe-..Tl':nq.................... ............... ............................... ... Loca'tion .....1.9.t..#i6....2 A..EggAy.th Ct. r ..................... . ..............................C.Q.tl4i.t.................................... J- < Owne�r .....WUli= ........ Type of Construction ........frame......................... ................................................................................ Plot ............................ Lot ................................ July 13 79 Permit Granted .........................................19 Date of Inspection ..... .....................19 Date Completed .1.0i ............. 19 17_77-77-7 PERMIT REFUSED., ....... .. ....... .... ........... . 19 ... .. . ... ... ............................ ... . .. ... .. ... . . .......... ..... .......... .. ...... .... . ... .. ........... ............. ................. .................... On A ed 19 ........................................... ................................................................................. ............................................................................... Assessors map and lot number ......... `. .... *THE ro 0 Sewage Permit number ....... -j................. ........:..................... ` 33ARNSTABLL Housenumber T.....,,. *.. .................................. - Z i y MA86 �O 1639• \0� DNA.A,, TOWN OF BARNSTABLE ` y5° BUILDING INSPECTOR v• u r W S 1.u��r: APPLICATION. FOR PERMIT TO � �1' - ..�.......'.`:�'.��.!.!?.�'�=..'�. TYPE OF CONSTRUCTION w�B�..........�RfF+til1% r 1 l/ �.%..19;aS TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location d/.... .....� E'S�/ 1.....C4u;P1...... dTr/i`% ...... �.... �r^l�,f ':��.......................................................... Proposed Use ... � ............ !!�i �.......N.. T%7r.`�N ....... E'S�% it/G��................................................................. Zoning District ..........................`..Fire District ...�•,�T,u��........................................................ ............................................ Name of Owner ,a ........Address ............................. �t'0.��,... i. �r<... Name of Builder r✓ .t/2. SSdc ................Addresses � p........a..7_.,,. ... ....................... .,.. :. ..... 3.�,. Name of Architect 's ' �?. ..... Address t �J Foundation ...�f�.�U n..........<....t!�.2LT� Number of Rooms ......:.............................................................. ` Exterior �'?�!�MQ....... �.........Roofing ........e:..s !4r� ..........� . !.'. ../P......................... Floors444'C......r .......�_..!`1- ' .....................................Interior .. .....Al,.T e/e........................................................... ...... ... !..`...........Plumbin ........./...:.... t!c�+�-r. Heating .;�.✓�?.... .. g 42 t c�sJ . ........................................Approximate Cost ��.� ')4 Fireplace .......................................... ..., Definitive Plan Approved by Planning Board ________________________________19________. Area � .,► ' Diagram of Lot and Building with Dimensions Fee " SUBJECT TO APPROVAL OF BOARD OF HEALTH ivy , { i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. !4'Name G/ f ' ............ &lexander, lliam a MazJ, v &=55-5� No —. l46% Permit for ���9�� �m �y.-- ' —� I. �'. �_--.------. �----.—C--�--.. Location .. _--------- —.—.--------.. i��' m o/ or Construction . ^ ' - J ' ' ' � .. ............... ........... ............................... ' 4r � ' ' '~' � Date of i . � Inspection . � upne Cox.F"e= PERMIT REFUSED . __. lA -- . --.. — ��� � ~ .............. —. —. ..r------- . . . � � y —'~--^^^o°~---''^^--~--^~------~' � —..--~.—...---.--..—...—.—.—.----- ' ' --------.~.--..----..-----~~. . Approved ' ^ ' ................................................ lg ' ~ � --------------^—^'—^----~---' , ^ ----^---'---'--^—~'—^—^—^''—^^—^' } Z 0 - ---- -- ----— — - -T Isi -_ =-- —_--_— - ----_- =�-—- - — -_——---__ --- ---- -- -- - -_ -_=---- v • --------- — - -- - - - -i-- —- - -- -- --------- ------- 12 CO Ln V X FFPl �J LTA O. ® a a T MT L El E =y R�T �o Q LPL J J W W f EXISTING REAR ELEVATION APROPOSED REAR ELEVATION o SCALE: 1/4" 1'--011 SCALE: 1/4" I'•-O" 0 w 0 OC LLI co Z a LU IMPORTANT w u o "•'STRUCTION THAT INCREASES UVING SPAC Ll U Q -D 1200 SQ, FT. PER LEVEL MAY REQUIRE TH �``L-,A--`N OF ADDITIONAL SMOKE D ITETECT w w ® ;� W SEPARATE PERMIT IS REQUIRED FOR TH Z OP.OF SMOKE DETECTORS-THE ELECTRICA PEn,,,,; 5 N T SATISFY THIS REQUIREMENT,. Q U EL, Ll Ell I J LL tl� SHEET LEFT ELEVATION S. RIGHT ELEVATION I SCALE: 1/4" - 1'-0" t SCALE: 1/4" . I'-O" • t` - JOB: ` 1002 DRAWN BY: KW { .. . � DATE: s CA Ot z All ° Z Qco cf) � � EXISTING STRUGTURE EXISTING BASEMENT U O O EXISTING �GREATE Cfl Ln SLIDER ACCESS U ALIGN _P ALIGN Z WALLS a � STUD '. I p �Ln - / lL i I RAIL j DROP WALL I5' I C2) 9 i/2' LVL GIRT ; ®/ —-—- - I DROP WALL 15° .STEP , o / :: , \\ o 3 1/2' DIA. STEEL COLUMN \\ I OL j 30a6ax12' CONCRETE PAD I � GRAVX/L SPACE I I G w 2852 M52 I ` I 2 CANCRETE sT CAP r. Ir 2� CONCRETE WALL # REHAR TOP #HOT to z6 CONTINUOUS F y� o OL �O (2) 9 1/2 LVL GIRT 3052 F 7 -—-—- FWH 3i611 --- --- l9 :mmw 04 MOO1.4 O Q o 2e52 O I I 5/50EANC 4OR BOLTS v I I W- 2852 EMBEDDED 7" 3 I I W Z SPACED 32" O.G. o I I 3 O 120 FROM CORNERS WASHERS 3°X31xl/4" Z !1 \MASONRY M IASONRY \�VENT — — VENT. 2862 FWH 6LYe11 2852 utj 1-011 4'—On L y 1. '- u 4:-Ou. 7 R 14'-Ou 4:_pn Lu 22'-0° 0° Q V Z Q Lu W Z (j) Q � , o 1 � N FIRST FLOOR PLAN FOUNDATION- PLAN 51-IFFY SCALE: 1/411 1'-O" SCALE: 1/4" 1'-0° A2 ..JOB- DRAWN BY: KW DATE: 7/9/10 J 1 _u 12 ----- __ — — ��— _ _ ---- --- 0) d — —— -- O C 00 L ® ® � m i, a a � . Q� Ll Ll L Iw J + yj O W v EXISTING REAR ELEVATION PROPOSED REAR ELEVATION o SCALE: 1/4" 0 1'-0" SCALE: I/4" 1* :_O" CV � � Q O � mL. � 3Z _— - —_--- - Q H Lu - --- - _ - -- --- - -= IMPORTANT z o ",'STRUCTION THAT INCREASES LIVING SPACE4 U Q \0 1200 SQ, FT. PER LEVEL MAY REQUIRE TH ``L-A-:ON OF ADDITIONAL SMOKE DETECTORS" w w ® JUL ® r _ w � L ® ® �� SEPARATE PERMIT IS REQUIRED FOR TIi.Oh OF SMOKE DETECTORS-THE ELECTRICALZ v PEn~" 2QUA' T SATISFY THIS REQUIREMENT. J /h U) C4 SHEET LEFT ELEVATION RIGHT ELEVATION 1 SCALE: 1/4" s 1'-0" SCALE: 1/4" m I'-0" JOB: 1002 DRAWN BY: py DATE: 7/9/10 A O/ F�} �1 J W O EXISTING STRUCTURE EXISTING B?SEMENT (rl � - '------ (V� X C EXISTING + 1 SLIDER �. ! CD Lf) a p= ALIGN 0 ALIGN AL STUD WL T __ l9 I I II— 1L I Rd+IL DROP WALL is' "` 1(2) 9 In' LVL GIRT'%i®/ I DROP WALL 15' e, W O \ I I STEPclk 71 3 1/2' DIA. STEEL COLUMN \ I J 36"6'x12' CONCRETE PAD � I ;I I CRAWL SPACE I :' I OL 2852 \\ \ \\ / / 2852 I I 2' GR�TfE�DUST CAP I I H to � 46 cOrKRETE WALL I I � O 2 RMAR TOP i HOT I I O 10 xlb CONTINUOUS FOOT� r FWH 316i1 a�-- ------ --------- 3�2 0 I I (2) 91/2' LVL GIRT n Q O 2852 / 285z I I NO qE= I I m O 5/8 ANCHOR BOLTS ci EMBEDDED 7" o b i i W Lii Z I I SPACED 32" O.C. 3 12" FROM CORNERS = WASHERS 30x3"xl/4" I = SONRY MASMRYVENT VENT Ylill --————— 2852 FWN &*11 2852 —— Lu Q 4'-O' 14'-0" 4'-0" 4'-0" 14'_0" 41_0" Z O 22'-0' 22'-0" LU Q Z U LU -J (Y LU (L Z (n > O J u- FIRST FLOOR PLAN FOUNDATION PLAN NN SCALE: 1/4" a I'-O° SCALE: 1/4" 0 1'-O" SHEET A 1 JOB: 1002 DRAWN BY: KW DATE: 7/9/10 Z " 0 OL J W � z � o cl o r- FLAT MI6' OC ■ \`I J� Ln —— —— —— —— � MEMBRANE � (8) 9 1/2 LVL 5/5' PLYWOOD SHEATHING/ 9 A\I� y FRAME 'B' 9 MATCwA EXISTING \\ (5) 9 1/2' LVIr/ MATCH EXISTING - -------- POLY ISO FOAM TOP PLATE-- — NO VENTING 2x109 INFIL \ \ \\ // I0s INFILL J i TYP_ EXTERIOR WALL 2x6 EXT. STUDS 0 16' O.G./ ~ 3-5EASON 1/2' PLYWOOD SI4EAT14ING/ W F FRAME B TYVEK WRAP/W.G. SHINGLES F_ ADDITION i // \\ IXISTINCr FIRST FLOOR ---- -- 19 INSULATION Q i i/ \\ SUNROOM FLOOR--- 2xIOx O 16b.C. W a 2XI09 INFIL 10a INFILL 19 INSULATION z /i \\ 2 9 1/2' LVL GIRT — I�1 can O // \\ 15,Xi i 3 1/2' LALLY COLUMN-----) n / \ II— gisil—MR A �I CRAWL SPACE rii �� y 3 Z P.T. SILL ANGNORED 32' O.G. + 0 \ 8'x46' CONCRETE WALL IZ // \ (2) u5 REBAR TOP ! HOT Z BO== DAMP PROOF BELOW GRADE O FRAME A 10'xI6' CONTINUOUS FOOTING Q 22'-0" G Q Q Z O ROOF FRAMING SECTION z � w SCALE: 1/4" I'-O" SCALE: 1/4" V-0" Q d) Nu � ~ J Z (n IL > O u- -A v � N N 51-IEET A3 JOB: 1001 DRAWN BY: KW DATE= _00 0 � 0 Zo O W � C) z � o � Q � c — o cl U � ° O JOINT DESCRIPTION NUMBER OF NUMBER of NAIL SPACING COMMON NAILS Box NAILS CD Ln ROOF FRAMING STAGGER NAILIN � 1� BLOCKING TO RAFTER (TOE NAILED) —T 2-Sd R 2-IOd EACH END INTO BOTH PLATES 2x6 DSL TOP PLATE V� IM BOARD 70 RAFTER (END NAILED 2-16d 3-16d EACH END rT�Q WALL FRAMING Q TOP PLATES AT INTERSECTIONS (FACE NAILED) 4-16d 5-16d AT JOINTS w STUD TO STUD (FACE NAILED) 2-Ibd 2-16d 24" O.C. r HEADER TO HEADER (FACE NAILED) I6d 16d 24° O.G. ALONG EDGES FLOOR FRAMING w VERTICAL Iw_- JOIST TO SILL, TOP PLATE OR GIRDER (TOE NAILED) 4-6d 4-I0d PER JOIST STRUCTURAL PANEL = Q Lq BLOCKING TO JOIST (TOE NAILED) 2-ed 2-IOd EACH END NAILED Bd COMMON Q BLOCKING TO SILL OR TOP PLATE(TOE NAILED) 3-16d 4-16d EACH BLOCK 3" O.C. EDGE7-7 OL AND 12" IN FIELD + Q -, LEDGER STRIP TO BEAM OR GIRDER(FACE NAILED) 3-16d 4-16d EACH JOIST rTl Q Q JOIST ON LEDGER TO SEAM(TOE NAILED) 3-5d 3-I0d PER JOIST w �L BAND JOIST TO JOIST (END NAILED) 3-16d 4-16d PER JOIST Zj BAND JOIST TO SILL OR TOP PLATE (TOE NAILED) 2-16D S-tbd PER FOOT Q ROOF SHEATHING w w WOOD STRUCTURAL PANELS ~J w O RAFTERS OR TRUSSES SPACED UP TO 16" O.C. Sol IOd 6" EDGE/6" FIELD = co RAFTERS OR TRUSSES SPACED OVER 16" O.C. 8d 10d 4° EDGE/6" FIELD <[C " Q GABLE ENDWALL RAKE OR RAKE TRUSS w/o GABLE OVERHANG 8d IOd 6" EDGE/6" FIELD GABLE ENDWALL RAKE OR RAKE TRUSS w/ STRUCTURAL Sd IOd 6" EDGE/6" FIELD OUTLOOKERS GABLE ENDWALL RAKE OR RAKE TRUSS w/ LOOKOUT BLOCKS 8d 10d 4" EDGE/4° FIELD CEILING SHEATHING GYPSUM WALLBOARD Sd COOLERS - 7° EDGE/10" FIELD 41 N WALL SHEATHING WOOD STRUCTURAL PANELS STUDS SPACED UP TO 24" O.C. Sd IOd 61 EDGE/12" FIELD _ AND %' FIBERBOARD PANELS 8d - 3° EDGE/6" FIELD Q s° GYPSUM WALLBOARD 5d COOLERS - 7" EDGE/10° FIELD tu FLOOR SHEATHING p WOOD STRUCTURAL PANELS 1" OR LESS Sd IOd 6" EDGE/1" FIELD GREATER THAN I" IOd 16d 6" EDGE/6" FIELD SWEET A4_ t JOB: IOOI DRAWN BY: KW DATE: V I, 1 �-T ` V1 M AY /8 PAbL mC)R RA.Y -ZN5;P, V * a < LOAM ANDvi \ SUBSOIL . `? 12 a ICJ N1EDl(uNi h O� w 4 I COTUIT SAND > Q a - ND LJA TEfq -EN%-:0L)N 7-ERE ass• j L _ L TOb-)N C.s�A Ti R A NVA ' 'A Io � .~X A4 i AJ/M U/t/I s C.d� L E /3'CJ/L01A,(G SETL3A ems- U/�E./`�IFiI/TS 4 Tc' \ )c 0 pO SED SE P T-/C 5 Y5 TAM CONS T2 UC T/ON SHALL CONFO.zM TO .�AsS . C E510AJ FLOW {, GAL�'p,4 v --/VVIeONML-NTAL. CODS T-/TL6- L G.,q C 14 2,4 TE C � . / /�/�.�//�,o X/ST'//VG ,r� v°iS a'7-/�-77£ 13AR1�/STACiI` ,e6gU12GD Z-E1ac:-IAeE�cJ3o 4 /S - A EA L TN 2�C,UL Q T/O/V5 ,U2 O F?O S.!= U L E 4C.L/ !-� —Al TOFF OF _ ~-- - - 2 "OF PE.� S7-OAJ a1, 56 i/��e�V/Our co✓E�. 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L CCAT/ON' /S CORRECT AS -5/-IUC.c)N ANC 17 DUES CCJICI P�.�' L l T ,l' ;`1t Q.t.f`Vlx GEORGE' -_- -' --- ---- - SETL3ACf� REQL/!/?EM f`f7" s '00 '.I �evr,_Q' Y ; 7'�1t.4jN 0,c &Ar?/y 5�JA � 4� \gip eu/sT��`��� ---- -- ---- --------- - -